INDEPTH Network — Leading research in Africa and Asia

Thursday, February 7, 2008 Pg 30 (Daily Graphic)
By Rebecca Kwei
Public health decision-making is critically dependent on the availability of sound data. One cannot but agree with the physicist Niels Bohr when he stated in 1930 that "nothing exists until it is measured".
Information is needed to effectively assess the extent to which health services are meeting the needs and demands of individuals and communities.
Similarly, health information is needed for strategic policy-making and resource allocation. Vital health information can only be obtained through adequate relevant data obtained from carrying out quality research.
Unfortunately, research is not a priority of most developing countries as they hardly make any budgetary allocation for population and health research. It is not surprising that developing countries continue to be overburdened by diseases often preventable with proven and effective technologies.
One international NGO working hard to bring reliable health information to bear on policy and planning in resource-constrained countries is INDEPTH Network.
Since 2000, INDEPTH Network, with a secretariat in Accra, has been making systematic efforts to harness and make widely available data from various Health and Demographic Surveillance Systems (HDSS) sites to fill the existing void in vital health information needed for planning.
Demographic surveillance over time looks at risk and corresponding dynamics in rates of birth, deaths, and migration in a population.
Surveillance systems are often set up around specific intervention studies and later converted into standing HDSS sites that can form a platform for further studies.
INDEPTH aims at developing into a network that builds key scientific blocks in poverty-related diseases such as malaria, HIV/AIDS and tuberculosis.
INDEPTH Network currently consists of 38 HDSS field sites in 19 countries that collectively monitor 2,200,000 people at a household level.
In Ghana, the sites are located at Dodowa, Kintampo and Navrongo. "Each site operates in geographically defined populations and conducts longitudinal, demographic monitoring, with timely production of data on all births, deaths, causes of death and migration", says Dr Ayaga Bawah, the Senior Research Associate of INDEPTH Network.
According to him, the collection of data in a well-defined area is done on a continuous basis and this helps to provide timely information for planning and service provision to communities.
INDEPTH Network’s research work is well guided in the cost-effective use of tools, interventions and systems to ensure and monitor progress towards national and international goals.
For instance, research generated from some of the INDEPTH sites in Ghana has resulted in the formulation of some national health policies. An example, Dr Bawah says, is the Community-based Health and Planning Services (CHIPS), which is now the government's policy for delivering health services to the people of Ghana.
Dr Bawah explained that the CHIPS approach had its origins in groundbreaking research carried out at the Navrongo Health Research Centre in Northern Ghana.
Another example is the use of insecticide-treated bednets whose pioneering research was also done at Navrongo. Again, the Dodowa District is being used to evaluate the National Health Insurance Scheme (NHIS).
Furthermore, among the scientific and policy findings that have been developed, tested and demonstrated by HDSS sites are the effectiveness of Insecticide Treated Nets (ITNs) in reducing the incidence of malaria mortality; the impact of expanding the health care workers on health outcomes in a community and the first real model life tables for sub-Saharan Africa, which had previously relied on estimates based on non-African populations.
One major boost of INDEPTH Network's projects for which Ghana is at the forefront is the establishment of the Malaria Clinical Trials Alliance (MCTA) in 2006 with a $17 million grant from the Bill and Melinda Gates Foundation to the INDEPTH Network.
The main goal of MCTA is to facilitate site preparation for the effective conduct of clinical trials for life-saving malaria interventions such as vaccines and drugs. MCTA is also supporting sites to develop tools to assess the disease profiles of countries while encouraging the wise use of resources in resource-constrained countries in Africa.
Currently, there are 16 trial sites in 10 African countries (Burkina Faso, Gabon, Ghana, Kenya, Nigeria, Malawi, Mozambique, Senegal, Tanzania and The Gambia) on the MCTA platform. An international Management Board headed by former Prime Minister of Mozambique, Dr Pascaol Mocumbi, was constituted.
Dr Osman Sankoh, the new Executive Director of INDEPTH Network, says prevention and control of malaria are critical steps for reducing the burden of malaria, and is happy that Ghana is playing a leading role through the work of MCTA.
The Kintampo site, for instance, is giving the country a lot of visibility.
Another issue of concern to Dr Sankoh is the effect of the rollout of anti-retrovirals (ARTs) in Africa.
"ARTs are being rolled out in many countries, but we still do not have concrete evidence about the effects of this rollout on individuals, populations and the health systems", he noted.
Dr Sankoh says that the INDEPTH Network intends to carry out research to evaluate those effects.
Dr Sankoh who took over the position of executive director in October 2007, said his vision was to make INDEPTH Network the reference point for policy makers when looking for empirical evidence for policy planning. Another area Dr Sankoh is passionate about is for INDEPTH to be seen as an efficient and effective organisation that can be counted on as a credible partner that is based right here in Africa and headed by an African. He was optimistic that maintaining and establishing partnerships with donor groups and partners was essential to realise INDEPTH's vision and mission.